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Original Investigation
July 24, 2006

Impact of Inflammation on the Relationship Among Alcohol Consumption, Mortality, and Cardiac Events: The Health, Aging, and Body Composition Study

Author Affiliations

Author Affiliations: Department of Aging and Geriatric Research, College of Medicine, Institute on Aging (Drs Maraldi, Cesari, Leeuwenburgh, and Pahor), and Division of Epidemiology, College of Public Heath and Health Professions (Dr Andresen), University of Florida, Gainesville; Department of Clinical and Experimental Medicine, University of Ferrara, Ferrara, Italy (Dr Volpato); Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, NC (Dr Kritchevsky); Laboratory of Epidemiology, Demography and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, Md (Dr Harris); Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pa (Dr Newman); Department of Medicine and Epidemiology and Biostatics, University of California, San Francisco (Dr Kanaya); Department of Preventive Medicine, University Of Tennessee Health Science Center, Memphis (Dr Johnson); Department of Community Medicine and Public Health, University of Lausanne, Lausanne, Switzerland (Dr Rodondi); and Geriatric Research, Education, and Clinical Center of the Malcolm Randall Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Gainesville (Dr Pahor).

Arch Intern Med. 2006;166(14):1490-1497. doi:10.1001/archinte.166.14.1490

Background  Uncertainty remains about the overall survival benefit of alcohol consumption and the mechanisms underlying the cardioprotective effect of light to moderate alcohol intake. Recent evidence suggests an anti-inflammatory effect of light to moderate alcohol consumption. We investigated the relationship of alcohol intake with all-cause mortality and cardiac events and evaluated whether this relationship is mediated or modified by inflammatory markers.

Methods  The analysis included 2487 subjects, aged 70 to 79 years, without baseline coronary heart disease (CHD) or heart failure (HF), participating in the Health, Aging, and Body Composition study. All-cause mortality and incident cardiac events (CHD and HF) were detected during a mean follow-up of 5.6 years. Alcohol consumption and serum levels of interleukin-6 (IL-6) and C-reactive protein (CRP) were assessed at baseline.

Results  A total of 397 participants died, and 383 experienced an incident cardiac event. Compared with never or occasional drinkers, subjects drinking 1 to 7 drinks per week had lower age-, sex-, and race-adjusted incidences of death (27.4 vs 20.1 per 1000 person-years, respectively) and cardiac events (28.9 vs 20.8 per 1000 person-years). After adjustment for confounders, compared with never or occasional drinkers, light to moderate drinkers (1-7 drinks per week) showed a decreased risk of death (hazard ratio [HR], 0.75; 95% confidence interval [CI], 0.56-1.00) and cardiac events (HR, 0.72; CI, 0.54-0.97). Adjustment for potential mediators, and particularly inflammatory marker levels, did not affect the strength of this association.

Conclusion  Light to moderate alcohol consumption was associated with significantly lower rates of cardiac events and longer survival, independent of its anti-inflammatory effect.